Provider Demographics
NPI:1619989019
Name:CEDARS SURGERY CENTER, LP
Entity Type:Organization
Organization Name:CEDARS SURGERY CENTER, LP
Other - Org Name:PREMIER SURGERY CENTER OF SANTA BARBARA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:W
Authorized Official - Last Name:ODELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-282-7472
Mailing Address - Street 1:121 GRAY AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93101-1800
Mailing Address - Country:US
Mailing Address - Phone:888-282-7472
Mailing Address - Fax:805-563-5410
Practice Address - Street 1:2420 FLETCHER AVE
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93105-4814
Practice Address - Country:US
Practice Address - Phone:805-898-1111
Practice Address - Fax:805-563-8095
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-13
Last Update Date:2013-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA050000545261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAS051470AMedicare ID - Type Unspecified